Observation After Cytoreductive Nephrectomy in Patients With Synchronous Not Completely Resected Metastases of Renal Cell Carcinoma
| Autor: | Christian U. Blank, Axel Bex, Roderick de Bruijn, John B. A. G. Haanen, Simon Horenblas, Teele Kuusk, Allard Noe, Kees Hendricksen |
|---|---|
| Přispěvatelé: | Urology, CCA - Cancer Treatment and quality of life |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
business.industry Urology medicine.medical_treatment 030232 urology & nephrology medicine.disease Debulking Systemic therapy Surgery Targeted therapy Metastasis Lesion 03 medical and health sciences 0302 clinical medicine Renal cell carcinoma Response Evaluation Criteria in Solid Tumors 030220 oncology & carcinogenesis Medicine In patient Radiology medicine.symptom business |
| Zdroj: | Urology, 109, 127-132. Elsevier Inc. de Bruijn, R E, Kuusk, T, Noe, A P, Blank, C U, Haanen, J B A G, Hendricksen, K, Horenblas, S & Bex, A 2017, ' Observation After Cytoreductive Nephrectomy in Patients With Synchronous Not Completely Resected Metastases of Renal Cell Carcinoma ', Urology, vol. 109, pp. 127-132 . https://doi.org/10.1016/j.urology.2017.06.048 |
| ISSN: | 0090-4295 |
| Popis: | Objective To determine the time-to-targeted therapy (TTT) in patients with not completely resected low-volume oligometastatic disease who were observed following debulking cytoreductive nephrectomy (CN) for metastatic renal cell carcinoma (mRCC). Methods Patients with synchronous mRCC with not completely resected low-volume metastases and in whom observation after CN was a multidisciplinary tumor board recommendation were identified from an approved institutional database. Patient data, International Metastatic Renal Cell Cancer Database Consortium (IMDC) risk, Fuhrman grade, site, and number of sites, time-to-progression (TTP), TTT, and overall survival (OS) were retrospectively analyzed. Results From 251 synchronous mRCC patients treated since 2006, 40 (15.9 %) were identified who underwent CN with observation as a result of low-volume multiple metastasis considered not completely resectable (19 single site and 21 with ≥2 sites). IMDC risk was favorable in 7, intermediate in 24, and poor in 9 patients. Median TTP was 6 (range 2-30) months and TTT was 16 (range 2-43) months. In 11 patients targeted therapy was further deferred by observation beyond Response Evaluation Criteria in Solid Tumors progression and in 10 patients by additional local therapy of the most rapidly progressing lesion. Median OS was 30 (range 2-71) months. Conclusion In patients with synchronous mRCC and not completely resected low-volume metastasis, the TTT following CN was substantial. Local therapy to control the most rapidly progressing lesion or observation beyond progression was an additional means to defer systemic therapy. |
| Databáze: | OpenAIRE |
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